Arterial pH and carbon dioxide tension as indicators of tissue perfusion during cardiac arrest in a canine model

M. G. Angelos, D. J. DeBehnke, J. E. Leasure

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background and Methods: Previous studies have shown that PaCO2 and end- tidal CO2 reflect coronary artery perfusion pressures during cardiac arrest. We investigated the relationship of coronary artery perfusion pressure to central arterial pH and PaCO2 values during resuscitation from cardiac arrest in a canine model. Twenty-four mongrel dogs were block randomized to three different resuscitation groups after induction of ventricular fibrillation and cardiac arrest: a) standard cardiopulmonary resuscitation (CPR) and advanced life support (n = 8); b) cardiopulmonary bypass (n = 8); or c) open-chest CPR (n = 8). Central arterial blood gases and perfusion pressures were monitored during cardiac arrest and during resuscitation. Results: Prearrest blood gases and hemodynamic values were similar between groups. Sixteen dogs from all three groups were successfully resuscitated. Survivors had significantly higher coronary artery perfusion pressure (p = .03), PaCO2 (p = .015), and lower pH (p = .01) values than nonsurvivors. There was no correlation of pH and PaCO2 during mechanical external CPR. However, after institution of the different resuscitation techniques, pH and PaCO2 each showed a statistically significant correlation (r2 = .50 and .33, respectively) with coronary artery perfusion pressure. Conclusions: Central arterial pH and PaCO2 monitoring during cardiac arrest may reflect the adequacy of tissue perfusion during resuscitation and may predict resuscitation outcome from ventricular fibrillation.

Original languageEnglish (US)
Pages (from-to)1302-1308
Number of pages7
JournalCritical care medicine
Volume20
Issue number9
DOIs
StatePublished - Jan 1 1992

Fingerprint

Heart Arrest
Carbon Dioxide
Resuscitation
Canidae
Perfusion
Coronary Vessels
Cardiopulmonary Resuscitation
Pressure
Ventricular Fibrillation
Gases
Dogs
Cardiopulmonary Bypass
Thorax
Hemodynamics

Keywords

  • blood gas analysis
  • carbon dioxide
  • cardiopulmonary arrest
  • cardiopulmonary bypass
  • cardiopulmonary resuscitation
  • catheterization
  • hemodynamics
  • oxygen delivery
  • pH
  • ventricular fibrillation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Arterial pH and carbon dioxide tension as indicators of tissue perfusion during cardiac arrest in a canine model. / Angelos, M. G.; DeBehnke, D. J.; Leasure, J. E.

In: Critical care medicine, Vol. 20, No. 9, 01.01.1992, p. 1302-1308.

Research output: Contribution to journalArticle

Angelos, M. G. ; DeBehnke, D. J. ; Leasure, J. E. / Arterial pH and carbon dioxide tension as indicators of tissue perfusion during cardiac arrest in a canine model. In: Critical care medicine. 1992 ; Vol. 20, No. 9. pp. 1302-1308.
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AB - Background and Methods: Previous studies have shown that PaCO2 and end- tidal CO2 reflect coronary artery perfusion pressures during cardiac arrest. We investigated the relationship of coronary artery perfusion pressure to central arterial pH and PaCO2 values during resuscitation from cardiac arrest in a canine model. Twenty-four mongrel dogs were block randomized to three different resuscitation groups after induction of ventricular fibrillation and cardiac arrest: a) standard cardiopulmonary resuscitation (CPR) and advanced life support (n = 8); b) cardiopulmonary bypass (n = 8); or c) open-chest CPR (n = 8). Central arterial blood gases and perfusion pressures were monitored during cardiac arrest and during resuscitation. Results: Prearrest blood gases and hemodynamic values were similar between groups. Sixteen dogs from all three groups were successfully resuscitated. Survivors had significantly higher coronary artery perfusion pressure (p = .03), PaCO2 (p = .015), and lower pH (p = .01) values than nonsurvivors. There was no correlation of pH and PaCO2 during mechanical external CPR. However, after institution of the different resuscitation techniques, pH and PaCO2 each showed a statistically significant correlation (r2 = .50 and .33, respectively) with coronary artery perfusion pressure. Conclusions: Central arterial pH and PaCO2 monitoring during cardiac arrest may reflect the adequacy of tissue perfusion during resuscitation and may predict resuscitation outcome from ventricular fibrillation.

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KW - ventricular fibrillation

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